Surgical site infection after hip fracture surgery: A systematic review and meta analysis of studies published in the United Kingdom

James Masters, David Metcalfe, Joon Soo Ha, Andrew Judge, Matthew L Costa

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Aims
This study explores the reported rate of surgical site infection after hip fracture
surgery in published studies concerning patients treated in the United Kingdom.

Patients and Methods
Studies were included if they reported on surgical site infection after any type of
surgical treatment for hip fracture. Each study required a minimum of 30 days
follow up and 100 patients. Meta-analysis was undertaken using a random
effects model. Heterogeneity was expressed using the I2 statistic. Risk of bias was
assessed using a modified Newcastle-Ottawa scoring (NOS) system.

Results
There were 20 studies reporting data from 88615 patients. Most were
retrospective cohort studies from single centres. The pooled incidence was 2.1%
(95%CI 1.54-2.62) across ‘all types’ of hip fracture surgery. When analysed by
operation type, the SSI incidences were: hemiarthroplasty 2.87% (95% CI-1.99%-3.75%) and sliding hip screw 1.35% (95% CI 0.78-1.93). There was
considerable variation in definition of infection used, as well as considerable risk
of bias, particularly as few studies actively screened participants for SSI.

Conclusions
Synthesis of published estimates of infection yield a rate higher than that seen in
national surveillance procedures. Biases noted in all studies would trend towards an underestimate, largely due to inadequate follow up.
Original languageEnglish
Number of pages90
JournalBone and Joint Research
Volume9
Issue number9
Early online date1 Sep 2020
DOIs
Publication statusE-pub ahead of print - 1 Sep 2020

Keywords

  • surgical site infection
  • hip fracture
  • epidemiology
  • meta analysis

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